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Circumcision and HIV
Apr 29, 2006

Hi Doc!

I have just read your response to a worried mother who wonders if her 18 year old gay son would be better electing for circumcision to "help prevent HIV transmission".

I have never heard of this. Whilst I have fully understood that it in no way means that using condoms would no longer be necessary, I have no notion of why circumcision may even be considered desirable for HIV prevention.

How does this work? What does it all mean?

Many thanks, Guy

Response from Dr. Frascino

Hi Guy,

Research suggests that certain cells on the inner lining of the foreskin are prime targets for HIV and also that tears and/or abrasions in the foreskin are fairly common and can increase the risk for acquiring HIV. That's the theory behind current research into using circumcision as an HIV-prevention tool. There has been some preliminary, rather unremarkable, data suggesting that men could lower their own risk of acquiring HIV by almost two-thirds and that infected men could reduce the risk of transmitting the virus to their female partners by almost 30 percent, if they were circumcised. However, the World Health Organization states it is premature to recommend circumcision until the results of two randomized controlled trials, involving nearly 8,000 people in Kenya and Uganda, are available. Preliminary results from these studies should be out sometime this summer. Even if the studies confirm the benefits of circumcision, it must be viewed in the context of a much broader prevention strategy that promotes condom use, testing, and treatment. Stay tuned to this site. We'll keep you posted on the age-old question, "to circ or not to circ!"

Dr. Bob



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